Hi to you all, I love this site you are all so knowledgeable! I was diagnosed with PA in 1992 when I was in my 30s, approx 2ys later when I had to change Dr's the GP said to me 'you know you must never take Folic Acid again' I said I didnt know (only ever given it in my many pregnancies) didn't give it another thought but I read on here that people with PA do take folic acid etc or have I mis understood? Would appreciate your thoughts. Many thanks. x

Sleepybunny is correct when she says that a lot of folate can mask the macrocytic anaemia one often finds with a B12 deficiency. That's the only reason to avoid it - if you suspect the patient is B12 deficient and you believe that macrocytic anaemia is the best way to diagnose that.

But in your case you know that you're B12 deficient and the only reason you'd check for macrocytic anaemia would be if you thought you weren't taking any B12. And 20% of people with PA don't have macrocytic anaemia anyhow.

So there is no reason at all why you shouldn't take folic acid and many reasons why you should.

Again, LisaHelen has it right when she says that a good multivitamin should have all the folic acid you need.

really difficult to understand why your GP would have said that though there was a period when the BCSH guidelines were very unclear on B12 and folate deficiency and many did interpret the way things were phrased as saying that you should not be treated with folic acid if you had a B12 deficiency - whereas what was really intended was that people should be treated for both folate and B12 deficiency if both are present - treating a folate deficiency and ignoring a B12 deficiency is a no-no.

For me it was the other way round. I was treated with b12 but my folate levels were so low for such a long time that my b12 injections weren't effective. Eventually I had to have 4 months of 5 mg folic acid and I keep that topped up with 800mcg of methyl folate and a b complex which includes 200 mcg folic acid. Your gp is completely wrong. If you are on b12 therapy you must keep your folate levels high.

"High levels of folate are normally okay as long as your vitamin B12 level is also normal. Cells need vitamin B12 to use folic acid and when vitamin B12 levels are too low, folic acid cannot be used and builds up in the blood." :

Sally Pacholok and various specialists also talk about the dangers of folic acid as well as masking B12 deficiency in this film :

Haemotologist's quote:

"If you treat someone with B 12 def. with folic acid, you can either precipitate neurological abnormalities or, if the patient already has neurological abnormalities, you can make them worse. So folic acid should never be given empirically unless the B12 status is normal."